Individual provider Active NPI

Alice U Li, M.D.

  • Pediatrics Physician
  • Ozone Park, NY
National Provider Identifier
1760524805
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
183693 Issued in NY
Practice address
9120 Atlantic Ave
Ozone Park, NY 11416-1527
Phone
(718) 641-8207
Fax
(718) 323-0414
NPI assigned
Feb 13, 2007
Last updated
Jul 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 183693 NY Primary

Addresses

Primary practice location

9120 Atlantic Ave
Ozone Park, NY 11416-1527

Mailing address

80 Marcus Dr
Melville, NY 11747-4230
Phone (631) 391-8366

Other identifiers 1

IdentifierTypeStateIssuer
01878344MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
183693NYMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1760524805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-8366",
            "fax_number": "631-454-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 ATLANTIC AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114161527",
            "telephone_number": "718-641-8207",
            "fax_number": "718-323-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "ALICE",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "183693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01878344",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.